Gasparovic I, Artemiou P, Hudec V, Hulman M
Bratisl Lek Listy. 2017;118(8):479-484. doi: 10.4149/BLL_2017_092.
Minimal invasive aortic valve replacement has become a routine procedure. In this study, we compared the outcomes between conventional and minimal invasive aortic valve replacement via the partial upper sternotomy that were performed in our Institution.
The 5 year survival and postoperative outcomes of 34 patients that underwent isolated MIAVR between the years 2010-2013 were compared with the outcomes of 34 randomly selected patients that underwent conventional AVR, after propensity match analysis.
There was no difference between the two groups concerning the early and late postoperative outcomes. MIAVR patients had a longer mean cross-clamp time (p = 0.002) and longer cardiopulmonary bypass time (p = 0.0005) compared to the AVR patients. 5 year mortality and survival were 4.17 % vs 16.67 % (p = 0.20) and 95.8 % vs 83.3 % (p = 0.37) in the MIAVR and AVR groups respectively.
This study showed a comparable 5 year survival and postoperative outcomes between the MIAVR and AVR groups. In our opinion, the minimal access aortic valve replacement can be performed safely with excellent long-term results in selected patients (Tab. 4, Fig. 1, Ref. 35).
微创主动脉瓣置换术已成为一种常规手术。在本研究中,我们比较了在我院通过部分胸骨上段切开术进行的传统主动脉瓣置换术和微创主动脉瓣置换术的结果。
在倾向匹配分析后,将2010年至2013年间接受孤立性微创主动脉瓣置换术的34例患者的5年生存率和术后结果与34例随机选择的接受传统主动脉瓣置换术的患者的结果进行比较。
两组术后早期和晚期结果无差异。与主动脉瓣置换术患者相比,微创主动脉瓣置换术患者的平均阻断时间更长(p = 0.002),体外循环时间更长(p = 0.0005)。微创主动脉瓣置换术组和主动脉瓣置换术组的5年死亡率和生存率分别为4.17% 对16.67%(p = 0.20)和95.8% 对83.3%(p = 0.37)。
本研究表明,微创主动脉瓣置换术组和主动脉瓣置换术组的5年生存率和术后结果具有可比性。我们认为,在选定的患者中,微创主动脉瓣置换术可以安全地进行,并取得优异的长期效果(表4,图1,参考文献35)。